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Effectiveness of PRP Pharmacopuncture for Chronic Neck Pain in Cervical Myofascial Syndrome of the Upper Trapezius

Not Applicable
Not yet recruiting
Conditions
Neck Pain
Myofascial Pain Syndrome
Registration Number
NCT07119255
Lead Sponsor
Indonesia University
Brief Summary

The goal of this clinical trial is to learn whether pharmacopuncture with Platelet-Rich Plasma (PRP) is effective for treating chronic neck pain in cervical myofascial syndrome related to the upper trapezius muscle. The main questions it aims to answer are:

1. Is pharmacopuncture with Platelet-Rich Plasma (PRP) effective in reducing chronic neck pain in patients with cervical myofascial syndrome related to the upper trapezius muscle?

2. Does PRP pharmacopuncture improve functional outcomes and quality of life in these patients?

3. Are there any adverse effects associated with PRP pharmacopuncture in this context?

Researchers will compare PRP pharmacopuncture to normal saline pharmacopuncture (placebo) to evaluate whether PRP provides greater effectiveness in reducing chronic neck pain in cervical myofascial syndrome related to the upper trapezius muscle.

Participants will:

* Receive a single session of pharmacopuncture therapy

* Undergo evaluations at week 2, week 4, and week 8 after the intervention

Detailed Description

This is a clinical trial study to evaluate the effectiveness of PRP pharmacopuncture in patients with chronic neck pain in cervical myofascial syndrome related to the upper trapezius muscle. Participants are 60 males/females aged 18-59 years. They will be divided into two groups: (1) PRP pharmacopuncture and (2) Normal saline (placebo) pharmacopuncture. Each participant will receive a single pharmacopuncture treatment. Therapy efficacy will be assessed at week 2, week 4, and week 8 after the intervention.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
72
Inclusion Criteria
  • Male or female, aged 18 to 59 years.
  • Experiencing neck pain for more than 3 months (chronic).
  • Neck pain classified as Grade I to III according to the Neck Pain Task Force classification.
  • Presence of referred pain pattern on physical examination consistent with the distribution of the upper trapezius muscle.
  • Visual Analogue Scale (VAS) score between 30 and 70 mm (out of 100 mm) during activity (e.g., daily activities or light exercise).
  • Willing to participate in the study until completion and has signed the informed consent form.
Exclusion Criteria
  • Hemoglobin level <13 g/dL for males or <12 g/dL for females.
  • Platelet count <150,000/μL.
  • Presence of fever (≥37.5°C).
  • Diagnosis of fibromyalgia.
  • Structural abnormalities of the cervical spine other than degenerative changes, such as fractures, cervical spine injuries, space-occupying lesions (SOL), infections, neoplasms, or systemic diseases confirmed by radiographic imaging.
  • History of cervical spine surgery.
  • Presence of tumors, wounds, or skin infections at the needle insertion site.
  • Diagnosed with blood disorders or currently taking anticoagulant or antiplatelet medications.
  • History of hypersensitivity reactions to acupuncture (e.g., metal allergy, severe atopy, keloids, or other skin hypersensitivities).
  • Uncontrolled cardiovascular disease or diabetes mellitus.
  • History of pharmacopuncture therapy to the upper trapezius muscle within the past 6 months.
  • Use of anti-inflammatory medication within the past 2 weeks.
  • Currently pregnant or breastfeeding.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Biomarker parametersbefore treatment (baseline) and 4 weeks after treatment

The serum concentration of interleukin-1 beta (IL-1β) and vascular endothelial growth factor (VEGF) will be measured as outcome biomarkers to evaluate inflammatory and angiogenic responses following the intervention.

Secondary Outcome Measures
NameTimeMethod
Visual Analogue Scalebefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

Pain intensity will be assessed using a 100 mm horizontal visual analogue scale, where 0 mm indicates "no pain" and 100 mm indicates "worst imaginable pain." Participants will mark the point on the line that best represents their perceived pain intensity.

Pressure Pain Thresholdbefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

Using the minimum force applied which induces pain, measured with algometer

Neck Disability Indexbefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

A questionnaire for measuring self-rated disability due to neck pain

Perceived Stress Scalebefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

psychological instrument for measuring the perception of stress. It assesses the degree to which individuals perceive situations in their lives as stressful over the past month. The scale consists of 10 items, each rated on a 5-point Likert scale ranging from 0 ("never") to 4 ("very often"). Total scores range from 0 to 40, with higher scores indicating greater perceived stress.

Pain Catastrophizing Scalebefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

a validated self-report questionnaire designed to assess catastrophic thinking related to pain. It consists of 13 items divided into three subscales: rumination, magnification, and helplessness. Each item is rated on a 5-point Likert scale ranging from 0 ("not at all") to 4 ("all the time"), with total scores ranging from 0 to 52. Higher scores reflect greater levels of pain catastrophizing.

Short-Form 12 Health Surveybefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

designed to assess health-related quality of life (HRQoL) across two main domains: physical and mental health.

Cervical Range of Motionbefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

To evaluate the degree of movement in cervical flexion, extension, lateral flexion, and rotation using a goniometer or inclinometer.

Craniovertebral Anglebefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

To assess head and neck posture, measured from lateral photographic analysis.

Size of Myofascial Trigger Point Nodulesbefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

The diameter (in millimeters) of hypoechoic nodules identified at active trigger point sites will be measured using B-mode ultrasound. Measurements will be taken in both longitudinal and transverse planes.

Resistive Indexbefore treatment (baseline), 2 weeks, 4 weeks, and 8 weeks after treatment

The resistive index of the local blood flow surrounding the trigger point area will be assessed using color Doppler and spectral Doppler ultrasound.

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